Date of Conferral

2014

Degree

Doctor of Nursing Practice (DNP)

School

Health Services

Advisor

Sue Bell

Abstract

Central-line catheters save lives, but they can also bring about complications, such as hospital-acquired infections. The Institute of Healthcare Improvement has collected data indicating that using proper insertion techniques and maintenance care, known as "the bundle," can prevent bloodstream infections associated with central lines. Progress has been made toward that end: The bundle has been used in intensive care units in a variety of hospitals and reportable central-line infections have decreased by 38%. However, because infections continue to occur inside and outside intensive care units, more needs to be done to protect all patients from these deadly infections. The purpose of this project was to initiate a dedicated central-line access team to insert and maintain all central-line apparatus at the target hospital. One month of data was collected before and after implementing the dedicated team approach and included when the order was written, when the central line apparatus was inserted, who inserted the central line, the number of infections, and the number of complications associated with the central-line apparatus. According to the results, complications, such as infections and occlusions--known to be associated with central lines--decreased twofold and placement delays decreased by 3 hours (57%). The results support the establishment of a committed multidisciplinary team to insert and maintain all central lines. Hospital safety and quality departments will be interested in the methods and outcomes of this project that reduced central line-associated bloodstream infections, decreased treatment delays, and saved the patient and the healthcare organization from costly additional services.

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